a loss so vast. the aca is not just above the expansion of medicaid or establishing an insurance exchange, it is about the hundreds of federal mandates and procedural requirements that have the escaped public attention, but to which we by law must obey. the fine print of the legislation is so complex, even the federal government struggles to understand it. the states cannot fully understand the impact on finances, systems changes, and operations. this law completely overwhelms society's safety net for the needy. there are a few problems in pennsylvania created by the aca. the law mandates that we expand our provider enrollment system to check with their medicare data. medicare databases cannot handle automated changes. we will have to add staff resources to respond to 100,000 inquiries every month. we are mandated to create separate databases to accommodate is exchanges and some databases like the masterfile, we have not been given access to. we adopt past medicaid rules radically changing the tailor- made renewal system that took years to refine and perfect. the verification system will
